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LUNG Cancer

Doctors spend a great deal of time determining what stage of lung cancer you have, so that they will be able to prescribe the most effective form of treatment. Below is a review of the treatment recommendations for each stage. Keep in mind that each case of cancer is different. Your exact treatment may vary from what you read here.

Stage I. Recommended treatment: surgical removal of the tumor.

Stage II. Recommended treatment: surgical removal of the tumor and lymph nodes, followed by radiation and/or chemotherapy.

If you have either Stage I or Stage II lung cancer, the surgery to remove your cancerous tumor is still a major operation, and it will probably take you many weeks, or even months, to regain your strength and energy. Recovery will vary from person to person, depending on your age, your health, and other factors. The muscles of your chest and arm on the side of your surgery may become weak and require special exercises to regain strength. Unfortunately, some pain and discomfort are common after such a surgery. Your doctor or nurse can help you manage the pain with medicines and other means.

For example, air and fluid often collect in the chest after lung surgery. To help relive this, patients are helped to turn, cough, and breathe deeply. This helps you expand the remaining lung tissue, get rid of excess air and fluid, and recover more quickly. Your doctor will generally prescribe respiratory therapy as well. This involves exercises and treatments to keep the lungs expanded and to prevent fluid buildup.

At first, you may feel shortness of breath after surgery, since there is now less lung tissue to supply the body with oxygen. For awhile, you may also have to limit your physical activities. Gradually, however, the remaining lung tissue will expand somewhat, making it easier to breathe.

Stage III-A. Recommended treatment: chemotherapy and radiation to shrink the tumor, followed by surgery to remove the remaining tumor.

Stage III-B. Recommended treatment: a combination of chemotherapy and radiation therapy to shrink the tumor.

Stage IV. Recommended treatment: a combination of chemotherapy drugs, to find the most effective ones.

Chemotherapy is a general term for any treatment (not just cancer treatment) involving the use of drugs. (The prefix "chemo" comes from a Latin word meaning "chemistry" or "drugs.") When used to treat cancer, chemotherapy is usually a combination of drugs taken over a course of several weeks or months, depending on your general health, the kind of lung cancer you have, and the extent to which it has spread in your body. Chemotherapy can be used to slow the cancer's growth, to prevent it from spreading, to relieve symptoms caused by the cancer, or to eliminate all cancer cells from the body. Even when chemotherapy cannot cure you of cancer, it can help you live longer and more comfortably.

Radiation therapy occurs when a beam of high-energy rays is directed at a tumor, to slow or stop tumor growth. (In effect, the radiation kills the tumor cells.) In some cases, radiation is used to shrink a tumor prior to surgical removal. After surgery, it can also be used to destroy any remaining cancer cells. Radiation and chemotherapy are often used together with, or in place of, surgery.

Like chemotherapy, the amount of radiation you receive, and the schedule for your treatments, depends on your particular circumstances. First you will meet with a radiation oncologist who, with your doctor, will decide the kind, amount, and frequency of radiation you receive.

Your treatment schedule will depend upon the total amount of radiation the oncologist decides you will need. This amount is divided into "daily doses" to make sure it works as well as possible, but does the least amount of damage to your normal cells. Radiation sessions normally go for several weeks at a time, followed by a rest period of a few weeks, before the next round begins.

Before your first radiation treatment, small "tattoos" will be placed on the area to be treated, to guide the X-ray instruments and ensure the beams of radiation are targeted precisely at the cancer. These marks are not permanent. However, you must not wash them off until your entire series of radiation treatments is completed.

Working with Your Doctor and Health Care Team

Your doctor will recommend a treatment program based on the stage of lung cancer you have. To help you understand what the doctors have found out about your cancer and what the side effects of the various treatments might be, we suggest you ask the following questions:

>> What is my diagnosis? What stage is the cancer?

>> What are the possible treatments for me? Which one do you recommend for me, and why? What are the potential benefits?

>> Will I have to stay in the hospital, or can I be treated as an outpatient (a patient who receives treatment during the day but goes home, and does not stay overnight)?

>> Should I consider joining a clinical trial? (See What is a Clinical Trial for more information.) If so, how can I find out more about it?

>> What are the potential risks and side effects of each treatment?

>> How long will the treatment last?

>> Will the treatment make me sick? What can I do to minimize this? Are there drugs to help?

>> In what ways will I need to change my normal activities because of the treatment?

>> How much will the treatment cost me? How do I find out how much of this cost is covered by my insurance?

It is also recommended that people with lung cancer be treated by a multidisciplinary team, meaning that a number of health care specialists will work together to develop and carry out your treatment. Each member of the team has a unique and important perspective to offer regarding your care. You may see a:

* Pulmonologist (a doctor who specializes in care of the lungs)
* Medical oncologist (a doctor who specializes in diagnosis and treatment of cancer)
* Radiation oncologist (a doctor who specializes in radiation treatment for cancer patients)
* Thoracic surgeon (a surgeon who specializes in surgery of the chest region)